Background: Liver injury related to Graves’ Disease (GD) includes hepatotoxicity of thyroid hormone excess, drug-induced liver injury, and changes resulting from concomitant liver disease. Methimazole (MMI) has been shown to induce several patterns of liver injury. However, the diagnosis and treatment of autoimmune hepatitis (AIH) overlapping with either GD or chronic hepatitis B are challenging. Case presentation: A 35-year-old man from China presented with a two-year history of GD and a 10-day history of progressive jaundice. He had taken MMI for two months and discontinuing treatment due to liver toxicity 1 year ago and for another 6 days 20 days prior to hospitalization. The patient was diagnosed with GD overlapping with chronic hepatitis B and MMI-induced liver injury with early stage of acute-on-chronic liver failure on admission. However, the elevated aminotransferase and bilirubin levels could not be controlled after correction of liver failure and effective control of HBV replication and hyperthyroidism by daily oral entecavir and one-time oral administration of 131-iodine. The patient underwent liver biopsy on the 43rd day of hospitalization, showing HBsAg expression on the membrane of hepatocytes and typical histopathological characteristics of AIH. He was finally diagnosed with GD overlapping with chronic hepatitis B and MMI-induced liver injury and AIH. The elevated aminotransferase and bilirubin completely returned to normal by 3-month glucocorticoid therapy and continuous entecavir treatment and there was no recurrence during a 6-month follow-up, suggesting that AIH in this patient is different from classical AIH or GD-associated AIH. Conclusions: GD together with AIH is a complex and difficult subject. It needs to be clarified whether MMI or HBV can act as a trigger for AIH in this patient.

New aquamarine deposits have been found around the world in recent years, and how to compare and distinguish aquamarines of different origin has become a significant problem. Aquamarines from Koktokay, Minas Gerais, and Namaqualand were collected for standard gemology tests, spectroscopy, and chemical analysis in this paper. The spectroscopy experiment included infrared spectroscopy and Raman spectroscopy. Chemical composition analysis comprises electron microprobe and laser ablation–inductively coupled plasma–mass spectrometry (LA-ICP-MS). The results show that infrared absorption peaks related to [Fe₂(OH)₄] and NaH are found in Koktokay and Minas Gerais aquamarines, respectively. Compared with other two origins, Namaqualand aquamarine have strongest type II water Raman peak related to alkali metal content. Compared with aquamarines from other sources, aquamarines from Xinjiang and Minas Gerais are characterized by relatively high aluminum and low alkali contents in chemical composition, while Namaqualand aquamarine have a high scandium content.

Representative cathodoluminescence and backscattered electron images of zircons, monazites, and apatites.

Representative cathodoluminescence and backscattered electron images of zircons, monazites, and apatites.